A.22.Counselling and Testing at Paediatric department of Kamuzu Central Hospital (KCH)
by M Phiri, R Weigel, P Kamthusi, F Ndege, Nyirongo Z, Biyo E, Phiri M, Gondwe M, Kazembe P, Mwansambo C
Objectives and Scope Few children were referred to Lighthouse VCT services from the paediatric wards. In order to increase uptake and meet the needs of HIV infected children and their families VCT was established within the paediatric department.
Methodology: A counsellor and a nurse were trained in child counselling. Lesson plans were developed and caregivers at paediatric wards were sensitised about VCT and HIV- related conditions. VCT register entries between opening in 10/04 until 02/05 were analysed.
Results: So far, 184 caregivers of 140 children (between 18 months and 14 years, 56% male) were counselled. In addition, caregivers of 15 children <18 months were offered diagnostic counselling and testing. Acceptance of HIV- testing was high in both children (91%) and adults (90%). About half of the children (46%) and their caregivers (51%) were HIV positive by using 2 different rapid tests kits. Among the caregivers tested, women were the majority 131/165 (79%), and 54% of them were HIV infected. Referral for further care was documented in only 22% of the adults and 53% of the children. Average daily workload at paediatric VCT increased from 2 clients in 10/04 to 4 clients in 02/04.
Conclusions: VCT at paediatrioc department includes both, mainly female caregivers and children. If counselled, HIV testing is usually accepted. The average daily workload is still low, but increasing.
Recommendations: Staff needs more sensitisation about benefits of VCT for children and caregivers. Referral to the ARV clinic and other services should improve. Adherence counselling for children on ARVs as well as support in disclosure of ARV status could be offered.